Golfer's decision to play through panic attack a textbook treatment strategy

When pro golfer Charlie Beljan broke down on the course in Lake Buena Vista, Fla., last Friday, dropping to one knee, trembling and clutching his chest in obvious pain and stress, the sporting world looked on, dreading the outcome while at the same time being unable to help.

Beljan, 28, was experiencing a panic attack. His throat was tightening, his heart was racing and he feared he could be having a heart attack.

But Beljan knew he needed to keep playing.

In his rookie season on the PGA Tour, and coming into the tournament ranked 139th, he needed a Top-10 finish to guarantee he would keep his Tour card for next year.

So Beljan gathered himself together, got back on the course, and played 18 more holes over five excruciating hours, winding up with an incredible score of 64 -- the second best of his rookie season. After the final hole, he was taken by ambulance to hospital, where he was was diagnosed as having had a panic attack.

After a night in hospital and a number of tests, he returned to the course on Saturday and played the final 36 holes, eventually winning the tournament -- his first on the PGA Tour and the final of the golf season -- and guaranteeing his spot for next year.

As it turns out, Beljan's decision to complete the round post-panic attack and still return the next day to face down his fears is a near-textbook strategy for overcoming the disorder, says Peggy Richter, a psychiatrist and director of Sunnybrook Health Sciences Centre's Clinic for OCD and Related Disorders.

"The wonderful news about panic attacks for people who don't know … is that they are safe," she told CTV's Canada AM. "For most people whose heart is OK and whose health is otherwise fairly good, there is no danger to them from a panic attack in and of itself. But staying away from situations and trying to avoid things is a sure recipe for leading to ongoing impairment."

In fact, one of the most effective techniques for treating panic disorders, Richter says, is a cognitive approach where the patient is encouraged to gradually re-enter the situation that triggered the panic attack and "challenge their anxiety until they overcome it."

That's exactly the type of behaviour Beljan demonstrated, she said, explaining that most people react by trying to avoid those situations at all costs, not wanting to re-experience the terrifying phenomenon.

Beljan has had a stressful year. It's his rookie season on the PGA Tour, the highest level of pro golf. And if that wasn't enough, he and his wife married earlier this year and recently welcomed their first child.

But Richter said panic attacks can happen to anyone, regardless of their circumstances. Those who are stressed out tend to be at higher risk, but people who have little or no stress in their lives can also be affected. In fact, a panic attack can even occur during sleep, Richter said.

"I think pressure certainly has a lot to do with it and people, when they're under increased pressure and lots of stress, when they're getting less sleep and there are other demands on them, will be at increased risk. But the interesting thing about panic attacks is they can happen to anyone at any time, anywhere," Richter said.

Panic attacks are often mistaken for heart attacks, she said, and are typically characterized by similar symptoms such as shortness of breath, rapid heart-rate, trembling, shaking, sweating, nausea, chest pain and a sensation of being smothered.

In addition to the cognitive therapy approach to overcoming panic attacks, medication is also standard treatment, Richter said.

Photos

In this image taken from video, golfer Charlie Beljan experiences a panic attack during a PGA Tour event in Florida.